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APPLICATION -- ZONE RECLASSIFICATION <br />SAN JOAQUIN COUtJTY CON",MUNITY DEVELOPMENT DEPARTMENT <br />FILE NO: ZR <br />Other <br />Describe any items of historical or archaeological interest on-sile (e.g. cemeteries or structures <br />Describe any on -silo or off-site sources of noiso or vibration (U- freeway nolse, head ogu!Ip ont, otc.Z <br />e <br />Descrbe any on-site or off-slte sources of light of glae (e.g. pirking lot 1 htina, or retleclive materials used): <br />Describe anyon-site or of(4- to source of odor (e,q. ac rlcullural wades): <br />\/E/�Ict6 Fm1tr�/ <br />Dc,cri -o any displace monl of people that will be caused by the project {e - g. numbers of people, housing units): <br />f <br />�k <br />AUTHORIZATION SIGNATURES <br />ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br />I, the OwnerlAgent agree, to defend, indemnify, and hold harmless the County and its agents, officers and ernployees from any claim, <br />action or proceeding against the County arising frons the OwnerrAgent's project. <br />further certify. under penalty of peujufy, that I am (check one). <br />Legal properly owner (owner indudes pwlner, trustee, grantor, or corporate officer) of the property(s) Involved In this <br />alMAcallon, or <br />e <br />❑ Legal agent (allach proof of the owner's consent to the application of the property's involved in this application and have been <br />authorirett to file on their behalf., and that the foregoing application statements are true and correct. <br />I f ✓a�.— <br />Print Name:-� 1�n 1 Gr. . Signature: flats: <br />Print Name; vr� f. -r �..� Signature:Date: t: .a i . t <br />Print Name: Signature. Date: <br />2--L114`ti l LLC. <br />t'rint Name: � �� � 1 _ _ Ssgnateue: ) Date; <br />Pnnt Name: � .� fr,&A-, Signalure: <br />MAI <br />FADE1J5V51f 1anNng Appllcaban FomnrAZONE REGI ASSIFICATION Page 5 of 5 <br />(REV. 05-1 t-09) <br />